Analysis of Bone Density in a Group of Patients with Dental Inclusion

Background/Aim: Genetic and environmental etiologic factors have been described for maxillary canine impaction, except for the trabecular bone characteristics in the impacted area. The aim of this study was to evaluate the surface area and bone density using cone-beam computed tomography (CBCT) images of patients with maxillary impacted canines. Material and Methods: The sample comprised preorthodontic treatment, CBCT images of 24 participants with unilateral maxillary impacted canines, using the impacted side as study group and the non-impacted side as control group. CBCT images were acquired in portrait mode (17 x 23 cm high field of view) at 120 kV, 5 mA, 8.9 seconds exposure time, and 0.3 mm voxel size. Each root was divided into three levels (cervical, intermediate, and apical) to determine whether the bone density change varied with the tooth level. Moreover, each level was divided into four regions (palatal, distal, mesial, and buccal sides). Bone density was measured using Hounsfield Units. Comparisons were made using paired t tests and linear regression. Repeated measurements were obtained randomly from about 20% of the sample. Results: In subjects with unilateral impactions, the maxillary bone density was higher in the impacted side, with a mean difference of 350 HU. Bone density increases in the corono-apical direction of about 100 HU in the impaction site and about 50 HU in the site of the erupted canine. The repeated measurements showed similar results. Conclusions: The maxillary alveolar bone area and bone density are increased in the impacted side compared with the nonimpacted side.